DOLCE INTERNATIONAL HOLDINGS, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN
401k plan membership statisitcs for DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2016: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 1,232 |
| Total of all active and inactive participants | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 0 |
| 2015: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 697 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 1,232 |
| Total of all active and inactive participants | 2015-01-01 | 1,232 |
| Total participants | 2015-01-01 | 1,232 |
| 2014: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 1,759 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 761 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 5 |
| Total of all active and inactive participants | 2014-01-01 | 766 |
| Total participants | 2014-01-01 | 766 |
| 2013: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 1,448 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 721 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 14 |
| Total of all active and inactive participants | 2013-01-01 | 735 |
| Total participants | 2013-01-01 | 735 |
| 2012: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 864 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 799 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 12 |
| Total of all active and inactive participants | 2012-01-01 | 811 |
| Total participants | 2012-01-01 | 811 |
| 2011: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 2,300 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 1,898 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 7 |
| Total of all active and inactive participants | 2011-01-01 | 1,905 |
| Total participants | 2011-01-01 | 1,905 |
| 2010: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 1,217 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 1,230 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 40 |
| Total of all active and inactive participants | 2010-01-01 | 1,270 |
| Total participants | 2010-01-01 | 1,270 |
| 2009: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 1,250 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 1,336 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 23 |
| Total of all active and inactive participants | 2009-01-01 | 1,359 |
| 2008: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-01-01 | 1,152 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-01-01 | 1,146 |
| Number of retired or separated participants receiving benefits | 2008-01-01 | 18 |
| Total of all active and inactive participants | 2008-01-01 | 1,164 |
| Measure | Date | Value |
|---|
| 2012 : DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2012 401k financial data |
|---|
| Total transfer of assets to this plan | 2012-12-31 | $754,468 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $754,468 |
| Total income from all sources (including contributions) | 2012-12-31 | $11,902 |
| Total of all expenses incurred | 2012-12-31 | $245,359 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $242,709 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $11,900 |
| Value of total assets at beginning of year | 2012-12-31 | $233,457 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $2,650 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Administrative expenses professional fees incurred | 2012-12-31 | $2,650 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $5,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $11,900 |
| Other income not declared elsewhere | 2012-12-31 | $2 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $206,008 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $-233,457 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $-521,011 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $15,549 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $15,549 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Employer contributions (assets) at beginning of year | 2012-12-31 | $11,900 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $242,709 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $754,468 |
| Did the plan have assets held for investment | 2012-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | BKD, LLP |
| Accountancy firm EIN | 2012-12-31 | 440160260 |
| 2011 : DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $754,468 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $769,249 |
| Total income from all sources (including contributions) | 2011-12-31 | $6,343,812 |
| Total of all expenses incurred | 2011-12-31 | $8,577,645 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $7,909,434 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $6,224,846 |
| Value of total assets at end of year | 2011-12-31 | $233,457 |
| Value of total assets at beginning of year | 2011-12-31 | $2,482,071 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $668,211 |
| Total interest from all sources | 2011-12-31 | $65 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Administrative expenses professional fees incurred | 2011-12-31 | $18,999 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $1,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $2,218,965 |
| Assets. Other investments not covered elsewhere at end of year | 2011-12-31 | $0 |
| Assets. Other investments not covered elsewhere at beginning of year | 2011-12-31 | $183,881 |
| Other income not declared elsewhere | 2011-12-31 | $118,901 |
| Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $9,717 |
| Total non interest bearing cash at end of year | 2011-12-31 | $206,008 |
| Total non interest bearing cash at beginning of year | 2011-12-31 | $160,555 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $-2,233,833 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $-521,011 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $1,712,822 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $15,549 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $1,564,883 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $1,564,883 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $65 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $450,176 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $4,005,881 |
| Employer contributions (assets) at end of year | 2011-12-31 | $11,900 |
| Employer contributions (assets) at beginning of year | 2011-12-31 | $572,752 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $7,459,258 |
| Contract administrator fees | 2011-12-31 | $649,212 |
| Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $754,468 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $759,532 |
| Did the plan have assets held for investment | 2011-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
| Accountancy firm name | 2011-12-31 | BKD, LLP |
| Accountancy firm EIN | 2011-12-31 | 440160260 |
| 2010 : DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2010 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $769,249 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $587,295 |
| Total income from all sources (including contributions) | 2010-12-31 | $8,491,924 |
| Total of all expenses incurred | 2010-12-31 | $9,346,666 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $8,522,842 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $8,375,686 |
| Value of total assets at end of year | 2010-12-31 | $2,482,071 |
| Value of total assets at beginning of year | 2010-12-31 | $3,154,859 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $823,824 |
| Total interest from all sources | 2010-12-31 | $764 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Administrative expenses professional fees incurred | 2010-12-31 | $24,385 |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $1,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $2,484,315 |
| Assets. Other investments not covered elsewhere at end of year | 2010-12-31 | $183,881 |
| Assets. Other investments not covered elsewhere at beginning of year | 2010-12-31 | $74,703 |
| Other income not declared elsewhere | 2010-12-31 | $115,474 |
| Administrative expenses (other) incurred | 2010-12-31 | $9,104 |
| Liabilities. Value of operating payables at end of year | 2010-12-31 | $9,717 |
| Total non interest bearing cash at end of year | 2010-12-31 | $160,555 |
| Total non interest bearing cash at beginning of year | 2010-12-31 | $36,213 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $-854,742 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $1,712,822 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $2,567,564 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $1,564,883 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $2,216,867 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $2,216,867 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $764 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $542,768 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $5,891,371 |
| Employer contributions (assets) at end of year | 2010-12-31 | $572,752 |
| Employer contributions (assets) at beginning of year | 2010-12-31 | $827,076 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $7,980,074 |
| Contract administrator fees | 2010-12-31 | $790,335 |
| Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $759,532 |
| Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $587,295 |
| Did the plan have assets held for investment | 2010-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
| Accountancy firm name | 2010-12-31 | BKD, LLP |
| Accountancy firm EIN | 2010-12-31 | 440160260 |
| 2016: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | This submission is the final filing | Yes |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2016-01-01 | Plan is a collectively bargained plan | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan is a collectively bargained plan | Yes |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan is a collectively bargained plan | Yes |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan is a collectively bargained plan | Yes |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan is a collectively bargained plan | Yes |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2010: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| 2008: DOLCE INTERNATIONAL HOLDINGS, INC. MEDICAL BENEFIT PLAN 2008 form 5500 responses |
|---|
| 2008-01-01 | Type of plan entity | Single employer plan |
| 2008-01-01 | Submission has been amended | Yes |
| 2008-01-01 | Plan funding arrangement – Insurance | Yes |
| 2008-01-01 | Plan funding arrangement – Trust | Yes |
| 2008-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2008-01-01 | Plan benefit arrangement - Trust | Yes |
| CIGNA DENTAL HEALTH OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95037 ) |
| Policy contract number | 3217168 |
| Policy instance | 4 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $6,429 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA DENTAL HEALTH OF KENTUCKY, INC. (National Association of Insurance Commissioners NAIC id number: 52108 ) |
| Policy contract number | 3217168 |
| Policy instance | 3 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $2,382 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA DENTAL HEALTH OF NEW JERSEY, INC. (National Association of Insurance Commissioners NAIC id number: 11167 ) |
| Policy contract number | 3217168 |
| Policy instance | 2 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2015-01-02 | | Insurance policy end date | 2015-12-31 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $5,238 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA DENTAL HEALTH OF CALIFORNIA,INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 3217168 |
| Policy instance | 1 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $2,619 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 ) |
| Policy contract number | 3217168 |
| Policy instance | 5 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $952 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 ) |
| Policy contract number | 3217168 |
| Policy instance | 6 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $177 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $3,459 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $177 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCTON COMPANIES LLC |
|
| CIGNA DENTAL HEALTH OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95037 ) |
| Policy contract number | 3217168 |
| Policy instance | 5 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $814 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $15,913 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $814 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCTON COMPANIES LLC |
|
| CIGNA DENTAL HEALTH OF VIRGINIA, INC. (National Association of Insurance Commissioners NAIC id number: 52617 ) |
| Policy contract number | 3217168 |
| Policy instance | 4 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $31 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $692 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCTON COMPANIES LLC |
|
| CIGNA DENTAL HEALTH OF NEW JERSEY, INC. (National Association of Insurance Commissioners NAIC id number: 11167 ) |
| Policy contract number | 3217168 |
| Policy instance | 2 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $669 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $13,146 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $669 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCTON COMPANIES LLC |
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| CIGNA DENTAL HEALTH OF CALIFORNIA,INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 3217168 |
| Policy instance | 1 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $405 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $7,611 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $405 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKTON COMPANIES LLC |
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| CONNECTICUT GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 48119 ) |
| Policy contract number | 3217168 |
| Policy instance | 3 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $699 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $13,838 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $699 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCTON COMPANIES LLC |
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| CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 ) |
| Policy contract number | 3217168 |
| Policy instance | 7 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $99 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $2,141 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $99 | | Insurance broker name | LOCTON COMPANIES LLC |
|
| CIGNA DENTAL HEALTH OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95037 ) |
| Policy contract number | 3217168 |
| Policy instance | 6 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $657 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $12,849 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $657 | | Insurance broker name | LOCTON COMPANIES LLC |
|
| CIGNA DENTAL HEALTH OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95037 ) |
| Policy contract number | 3217168 |
| Policy instance | 5 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $46 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $714 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46 | | Insurance broker name | LOCTON COMPANIES LLC |
|
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 48119 ) |
| Policy contract number | 3217168 |
| Policy instance | 4 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $698 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $13,562 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $698 | | Insurance broker name | LOCTON COMPANIES LLC |
|
| CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47041 ) |
| Policy contract number | 3217168 |
| Policy instance | 3 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $245 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $4,997 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $245 | | Insurance broker name | LOCTON COMPANIES LLC |
|
| CIGNA DENTAL HEALTH OF NEW JERSEY, INC. (National Association of Insurance Commissioners NAIC id number: 11167 ) |
| Policy contract number | 3217168 |
| Policy instance | 2 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 47 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $752 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $14,990 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $752 | | Insurance broker name | LOCTON COMPANIES LLC |
|
| CIGNA DENTAL HEALTH OF CALIFORNIA,INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 3217168 |
| Policy instance | 1 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $275 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $5,710 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $275 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKTON COMPANIES LLC |
|
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 3217168 |
| Policy instance | 1 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 1546 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,853 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $498,952 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,853 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKTON COMPANIES LLC |
|
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 3217168 |
| Policy instance | 1 |
| Insurance contract or identification number | 3217168 | | Number of Individuals Covered | 1898 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $4,071 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | PREPAID DENTAL | | Welfare Benefit Premiums Paid to Carrier | USD $530,957 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 715825 |
| Policy instance | 1 |
| Insurance contract or identification number | 715825 | | Number of Individuals Covered | 1230 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $546,984 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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